Efficacy of salbutamol-ipratropium bromide nebulization compared to salbutamol alone in children with mild to moderate asthma attacks

Matahari Harumdini (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Bambang Supriyatno (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Rini Sekartini (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)

Paediatrica Indonesiana
Vol 52 No 4 (2012): July 2012

Background The efficacy of salbutamol-ipratropiumbromidenebulization in children with moderate asthma attacks remainsunclear, and studies on patients with mild attacks have beenrelatively few, especially in Indonesia. However, it is commonpractice for this drug combination to be given to patients withmild􀁓moderate asthma attacks.Objective To compare the efficacy of salbutamol􀁓ipratropiumbromide nebulization to salbutamol alone in children v.ith mildto moderate asthma attacks.Methods This single-blind, randomized clinical trial was heldin the Department of Child Health at Cipto MangunkusumoHospital, the Tebet Community Health Center, and the MHThamrin Salemba Hospital on children aged 5􀁓18 years withmild to moderate asthma attack. We randomized subjectsto receive either 2.5 mg salbutamol plus 0.5 mg ipratropiumbromide (experimental group) or 2.5 mg salbutamol alone(control group). Nebulization was given twice, with a 20minute interval between treatments. We assessed clinicalscores, vital signs, oxygen saturations, and peak flow rates(PFRs) at baseline, and every 20 minutes up to 120 minutespost-nebulization .Results A total of 46 patients were randomized to either theexperimental or the control group. Subjects had similar baselinemeasurements. At 20 minutes post􀁓nebulization, the percentageincrease of PFR was 19% higher in the experimental group(p􀀽O.OI, 95% CI 1.8 to 47.2). The proportion of PFR reversibilitywas 27% higher in the experimental group, although this resultwas statistically insignificant (P=0.06, 95% CI 0.03 to 0.52).There were no significant differences in clinical scores, oxygensaturations, respiratory rates, or hospitalization rates between thetwo groups. Side effects also did not differ significantly.Concl usion Salbutamol􀁓ipratropium bromide nebulizationimproved PFR measurements better than salbutamol alone.However, other clinical parameters were not significantly differentbetween the two groups. [paediatr lndones. 2012;52:200,8].